Title X Assurance of Compliance

Grants Process Policy Notice 97- 03

Exhibit C

________________________ assures that it will:
(Name of Organization)

1. Provide services without subjecting individuals to any
coercion to accept services or coercion to employ or not
to employ any particular methods of family planning.
Acceptance of services must be solely on a voluntary
basis and may not be made a prerequisite to eligibility
for, or receipt of, any other services.

2. Provide services in a manner which protects the dignity
of the individual.

3. Provide services without regard to religion, race, color,
national origin, handicapping condition, age, sex, number
of pregnancies, or marital status.

4. Not provide abortions as a method of family planning.

5. Provide that priority in the provision of services will
be given to persons from low income families.

Further, ________________________ certifies that it will:
            (Name of Organization)

1. Encourage family participation in the decision of minors
to seek family planning services.

2. Provide counseling to minors on how to resist coercive
attempts to engage in sexual activities.

From Part 59--Grants for Family Planning Services, Subpart A,
Section 59.5(a) 2, 3, 4, 5, and 6.


________________________
(Signature)

________________________
(Title)

________________________
(Date)